Provider Demographics
NPI:1740884774
Name:DALTON, SARAH FERGUSSON (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:FERGUSSON
Last Name:DALTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 PIKE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-7340
Mailing Address - Country:US
Mailing Address - Phone:804-594-0185
Mailing Address - Fax:804-594-0426
Practice Address - Street 1:151 PIKE VIEW DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-7340
Practice Address - Country:US
Practice Address - Phone:804-594-0185
Practice Address - Fax:804-594-0426
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist